CT Acquisition Protocol Groundwork

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Goal:

Proposed Protocol

Q. Should we propose two protocols 1) for high resolution; and (2) for world-wide trials in patients with late stage disease?

Or maybe we should define a several protocols with different "quality" scores
- Early stage disease is a different beast than later stage disease in terms of how they appear, how they should be imaged and how successful different kinds of image processing and measurement

<Lets start with a blend of NLST and ACRIN 6678 (see below)>

<Should seriously consider "raising the bar" to take a little more advantage of newer scanners>

Factors and Issues

The potential advantages of setting the parameter bar high:

better images
lower dose
...

need to be balanced against the costs:

fewer scanners will be able to meet the requirements
fewer sites will be able to follow the profile/participate in a related trial
prior studies and baseline data that followed the "lower bar" may no longer be comparable

Related Work

Defining Acquisition Protocols

ACRIN has defined a number of protocols for CT-based clinical trials.

CT Lung Specific protocols and QA procedures are discussed in work done for the ACRIN National Lung Screening Trial
- Table provides comparable acq. parameters for different scanners (16-18 models)
- Maps corresponding differences in terms and header details
ACRIN 6678 is a diagnostic-oriented (less concern on dose) that also does similar work
- Does not appear to have the comprehensive table of parameters that NLST does
- FOV (Field of View) is an issue because of interactions between the needs of CT and PET

Reviewing Acquisition Protocols

UPICT is preparing a process for proposing/reviewing protocols and has access to experts for reviews.

It would likely be beneficial to review our proposed protocols with them.

Storing/Transfering Acquisition Protocols

DICOM is working on a format for encoding acquisition protocols as DICOM objects which can be stored/retrieved.

Field Testing Acquisition Protocols

Q. Should we broadcast our proposed protocols for general use in pharma trials that are starting up now, before we complete our profiles and groundwork?